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Ask an Expert: Food allergies and holidays

With holiday parties upon us, what do you do if your child has a diagnosed food allergy? EdNews Parent sat down with Daniel Searing, a pediatric allergist at National Jewish Health, to get some help for parents.

Q. How can I ensure that the food my child eats at a holiday party is safe?

A. It is essential to make sure that the school nurse, teacher and even other classroom parents are notified and aware of your child’s food allergy. Even if your child has never had a severe, anaphylactic reaction, if they have been diagnosed with a food allergy by an allergist, this possibility exists.  Unfortunately, past reactions do not predict future reactions.  Anaphylaxis is a severe allergic reaction, that can be life threatening. Food intolerances are a different category of adverse food reactions than food allergies. Food intolerances can also cause uncomfortable symptoms that may need treatment, but generally are not life-threatening.
For a younger child, you can lower their risk for exposure by making your child’s treat for them. Or, if you’re up to it, become the “room parent” who makes the school party treats.

Older children should examine the labels of any wrapped food for possible allergens that they need to avoid.

Q. Should my child bring an EpiPen to school?

A. Yes, all children with food allergies should have an epinephrine injector stored at their school, as well as at home, along with a food allergy action plan that gives indications for using injectable epinephrine. It’s important for someone at school to be trained in how to administer the epinephrine injector. (video link- How to correctly use an EpiPen)

Q. Am I the only one who feels uncomfortable about sending my allergic child to school?

A. School can be stressful for parents and children with food allergies. You have less control of the environment. If you are uncomfortable with how your child’s food allergies are being managed at school, more education of the school personnel is likely warranted. Your doctor can help you communicate safety measures that the school should take if needed.

Q. Are there other resources I can consult?

A. Plenty. Here’s a list:

Q. If we’re headed to a holiday party, what should we bring – other than “safe” treats and food?

A.  Medications (both an antihistamine, as well as epinephrine (EpiPen). Bring them along.

Q. What if people are coming to our house?

A. Communicate with them about what should be avoided. The holidays are a time when new and different foods can come out, such as mixed nut jars. Turkeys are basted with different things that may have wheat, egg or soy. Examining labels and asking what is in things is key. The bottom line is, if you don’t know what you’re eating, don’t eat it.

Q. Are non-allergic people getting better or worse at helping people with food allergies avoid a reaction?

A. I think awareness is improving, especially over the last five to 10 years. The prevalence of food allergies has risen over that same time period, so schools are having to deal with it more and more.  I think there are still areas to improve, such as correctly diagnosing food allergies.

Q. Are more people being diagnosed with food allergies?

A. The prevalence of food allergies is certainly rising – but we don’t know why for sure.  There may be genetic, dietary, and exposure factors that are contributing to the increased prevalence of food allergies. According to a series of telephone surveys over time, the prevalence of peanut allergy in the U.S. rose significantly from .4 percent in 1997 to 1.4 percent in 2008.

Q. What are the most common food allergies?

A. The majority of food allergies are due to milk, egg, wheat, peanut, soy, fish, shellfish and tree nuts. About 3-4% of the general population has food allergy.

Q. Are children being diagnosed with peanut allergies at the same rate around the world?

A. An interesting line of research involves introduction of certain foods, such as peanuts, at very young ages. For instance, the prevalence of peanut allergies in the United Kingdom is similar to the U.S. However, when you compare prevalence of peanut allergy between ethnically similar populations in Israel and the United Kingdom, there is a ten-fold reduction in peanut allergy prevalence in Israel. Peanut is typically introduced earlier, eaten more frequently, and in higher amounts than in Israel compared to the UK.

This data and subsequent studies suggests that early consumption may play a role in inducing tolerance to foods. Further studies on this issue are currently underway.

Q. Does that mean I should slowly reintroduce foods my child is allergic to?

A. No. There are no approved protocols for inducing tolerance to foods in allergic patients.  There are research trials looking at this issue, including some that National Jewish Health has participated in.  For information on this research, visit the website for the Consortium of Food Allergy Research (CoFAR): http://www.cofargroup.org/.

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